Spinal cord stimulation uses a small implanted device to send mild electrical pulses to the spinal cord, changing how pain signals reach the brain. It’s an option for some people living with chronic back, leg or nerve pain that hasn’t improved enough with medication, injections, physical therapy or surgery. You can try it first with a temporary trial before deciding on a long-term implant.
A spinal cord stimulator has two main parts: thin wires called leads, which are placed in the epidural space along the spinal cord, and a small battery-powered generator, similar to a pacemaker, placed under the skin.
The device delivers low-level electrical signals to the spinal cord. Depending on the system and settings, those signals may mask pain with a mild tingling sensation or reduce pain signals without any tingling at all. You control the settings with a handheld remote or app, and they can be adjusted over time.
Spinal cord stimulation therapy doesn’t remove the cause of pain. Its goal is to lower pain enough to improve daily function and, for some people, reduce reliance on pain medication.
sometimes called failed back surgery syndrome
Narrowing of the spinal canal that can crowd the nerves.
Nerve irritation in the neck that can cause pain, tingling or numbness in the arm.
based on your provider’s evaluation
Spinal cord stimulation is usually considered when:
Many insurers and providers also require a psychological evaluation before a trial. This is a standard part of the process, not a judgment about your pain. Your provider will walk you through every requirement.
During a trial, temporary leads are placed through a needle into the epidural space, and they connect to an external device you wear on a belt. There’s no incision for the generator. For about a week, you go about your normal routine and track your pain, sleep and activity.
After the trial, the leads are removed. If your pain improved meaningfully and you’re happy with how the stimulation felt, you and your provider may discuss a permanent implant.
The permanent system is placed during a minor surgical procedure, and the generator sits under the skin, usually in the lower back or buttock.
After the trial, most people return to their routines right away, with some limits on bending, twisting and lifting so the leads don’t shift.
After a permanent implant, you’ll have activity restrictions for several weeks while the leads settle. You’ll have follow-up visits to check the incisions and fine-tune the programming. Most people gradually return to daily activities as they heal. Your care team will give you specific instructions.
Possible risks include infection, bleeding, lead movement that requires reprogramming or repositioning, discomfort at the generator site, headache and, rarely, nerve injury. Some devices require recharging, and batteries eventually need replacement. You’ll also need to check MRI compatibility and device precautions before any future scan or procedure.
Spinal cord stimulation doesn’t work for everyone, which is why the trial matters.
Call our office if you notice redness, swelling, warmth or drainage at an incision or the generator site, a fever, a sudden change in your stimulation, new numbness or weakness, or a headache that doesn’t ease when you lie down.
Seek emergency care right away if you lose control of your bladder or bowels, have sudden weakness in your legs, or have severe back pain with fever.
Many insurance plans cover spinal cord stimulation when specific criteria are met, which often include documentation of prior treatments and a psychological evaluation. Prior authorization is typically required. Our team can help guide you through the process.
The system is designed for long-term use, but it can be adjusted, turned off or removed if needed.
Some systems create a mild tingling sensation over the painful area. Others work without noticeable tingling. Your provider can explain the options.
Many newer systems are MRI-conditional, meaning MRI is possible under specific conditions. Always tell your care team you have a device before any scan.
A trial typically lasts several days to about a week. It gives you a real-life test before making a decision.
Some people are able to reduce pain medication with the help of their provider, but results vary.
Living with chronic pain that hasn’t responded to other care? Schedule an evaluation at our Rego Park, Queens office to talk through your options.
